{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T21:34:47Z","timestamp":1793136887796,"version":"4.5.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,5,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In calcific aortic valve disease on tricuspid aortic valves (\n              <jats:styled-content style=\"fixed-case\">TAVs<\/jats:styled-content>\n              ), men have higher aortic valve calcification and less fibrosis than women. However, little is known in bicuspid aortic valves (\n              <jats:styled-content style=\"fixed-case\">BAV<\/jats:styled-content>\n              ). We thus aimed to investigate the impact of age, sex, and valve phenotype (\n              <jats:styled-content style=\"fixed-case\">TAVs<\/jats:styled-content>\n              versus\n              <jats:styled-content style=\"fixed-case\">BAVs<\/jats:styled-content>\n              ) on fibro\u2010calcific remodeling in calcific aortic valve disease.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We included 2 cohorts: 411 patients who underwent multidetector computed tomography (37% women) for aortic valve calcification density assessment and 138 explanted aortic valves (histological cohort; 50% women). The cohorts were divided in younger (&lt;60\u00a0years old) or older patients with\n              <jats:styled-content style=\"fixed-case\">BAV<\/jats:styled-content>\n              (\u226560\u00a0years old), and\n              <jats:styled-content style=\"fixed-case\">TAV<\/jats:styled-content>\n              patients. In each group, women and men were matched. Women presented less aortic valve calcification density than men in each group of the multidetector computed tomography cohort (all\n              <jats:italic>P<\/jats:italic>\n              \u22640.01). Moreover, in women, younger patients with BAV had the lowest aortic valve calcification density (both\n              <jats:italic>P<\/jats:italic>\n              =0.02). In multivariate analysis, aortic valve calcification density correlated with age (\u03b2 estimate\u00b1standard error: 6.5\u00b11.8;\n              <jats:italic>P<\/jats:italic>\n              =0.0004) and male sex (109.2\u00b118.4;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), and there was a trend with\n              <jats:styled-content style=\"fixed-case\">TAVs<\/jats:styled-content>\n              (41.5\u00b123.0;\n              <jats:italic>P<\/jats:italic>\n              =0.07). Women presented a higher collagen content than men (77.8\u00b110.8 versus 69.9\u00b112.9%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) in the entire cohort. In women, younger patients with BAV had denser connective tissue than\n              <jats:styled-content style=\"fixed-case\">TAV<\/jats:styled-content>\n              and older patients with BAV (both\n              <jats:italic>P<\/jats:italic>\n              \u22640.05), while no difference was observed between men.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In calcific aortic valve disease, women had less calcification and more fibrotic remodeling than men, regardless of the phenotype of the valve or age of the patient. Moreover, younger women with BAVs had less valve calcification. Thus, mineralization\/fibrosis of the aortic valve is likely to have sex\/age\u2010specific mechanisms and be influenced by the valve morphology.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.015610","type":"journal-article","created":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T16:16:16Z","timestamp":1588954576000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":114,"title":["Age, Sex, and Valve Phenotype Differences in Fibro\u2010Calcific Remodeling of Calcified Aortic Valve"],"prefix":"10.1161","volume":"9","author":[{"given":"Martine","family":"Voisine","sequence":"first","affiliation":[{"name":"Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec\/Qu\u00e9bec Heart and Lung Institute Universit\u00e9 Laval Qu\u00e9bec City Qu\u00e9bec 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